Constipation with severe abdominal pain

Introduction Constipation with severe abdominal pain, bloating and vomiting, often prompted acute constipation. Acute constipation refers to constipation that occurs suddenly in the near future, including organic constipation and temporary functional constipation. It is caused by acute diseases such as intestinal obstruction, intestinal paralysis, acute peritonitis, cerebrovascular accident, acute myocardial infarction, and perianal pain. Mainly manifested as the clinical manifestations of the primary disease. Symptoms may be related to dysmotility of the bowel movements and may also be related to mental factors. Because the feces are dry and hard, or in the form of sheep feces, the patient may have discomfort such as lower abdominal pain, falling feeling, etc. during defecation. Sometimes the left lower abdomen can touch the sigmoid colon of the sausage-like sputum.

Cause

1, colonic obstruction: intussusception, intestinal torsion, intestinal parasites, mesenteric vascular embolization or thrombosis, etc., can cause colonic obstruction and acute constipation.

2, reflex anal sphincter spasm or inhibition of bowel movement reflex: anal fissure, external hemorrhoids, anorectal abscess, etc., due to bowel pain, reflex caused by anal sphincter spasm or inhibition of bowel reflex, and acute constipation.

3, drug factors: due to food service morphine, opioid, atropine, codeine, can cause acute constipation.

4, life rules and sudden changes in the environment: such as business trips, travel, work stress, etc. can also cause acute constipation.

5, mental strikes, psychological trauma, etc. can also cause acute constipation.

6, spinal trauma, surgical anesthesia can cause acute constipation.

an examination

Related inspection

Pelvic floor electromyography gastrointestinal imaging

In the diagnosis and differential diagnosis of constipation, according to clinical needs, the necessary examination should be done. First of all, we must pay attention to the existence of evidence of alarm symptoms and other organic diseases in the body. For patients over 50 years of age with a history of long-term constipation and aggravation of symptoms in the short term, colonoscopy should be performed to rule out colorectal tumors. For long-term abuse of laxatives, colonoscopy can determine the presence or absence of a cathartic colon or (and) colonic melanosis, and barium enema can contribute to the diagnosis of Hirschsprung's disease. OOC, anal digital examination, and faecal angiography are all necessary. Special examination methods include: gastrointestinal transit test (GITT), rectal and anal analgemetry (RM), rectal-anal reflex examination, tolerance sensitivity test, balloon expulsion test (balloonexpulsion test, BET), pelvic floor electromyography, pudendal nerve latency test and anal canal ultrasonography, these tests are only selected for refractory constipation.

Differential diagnosis

1, frequent vomiting and constipation are common symptoms of abdominal hernia. The intra-abdominal organ is called the intra-abdominal hernia from its original position, through a normal or abnormal channel or fissure in the abdominal cavity to an abnormal sulcus.

2, diarrhea, commonly known as "diarrhea", is one of the common symptoms of the digestive tract that everyone is familiar with. Constipation is just the opposite. The stool is not dry enough, and every time the stool is very laborious. The alternating diarrhea and constipation refers to a period of time, not constipation or diarrhea, which alternates. Sometimes constipation for several days, then suddenly diarrhea. If there is an exchange of diarrhea and constipation, you should be alert to colitis.

3, abdominal pain with diarrhea: is one of the symptoms of acute gastroenteritis. Mainly manifested as nausea, vomiting, abdominal pain, diarrhea, fever, etc., severe cases can cause dehydration, electrolyte imbalance, shock and so on. Most of the patients showed nausea, vomiting first, followed by diarrhea, 3 to 5 times or even tens of days a day. The stool was mostly watery, dark yellow or green, stench, may be accompanied by abdominal cramps, fever, Symptoms such as body aches.

4, constipation with abdominal mass: may be colon tumor, intra-abdominal tumor compression colon, intestinal tuberculosis, Crohn's disease (Crohn disease) or swollen lymph nodes. Intestinal tuberculosis is the most common tuberculosis in the digestive system. The vast majority are secondary to extraintestinal tuberculosis, especially hollow tuberculosis. According to statistics, 25% to 50% of tuberculosis patients can be complicated by intestinal tuberculosis. The source of intestinal tuberculosis is mainly ingestive, caused by swallowing sputum containing tubercle bacilli, occasionally from food contaminated by tuberculosis, or directly from blood-borne or abdominal, pelvic other organs spread. The age of onset is mostly young and middle-aged, with more women than men, about 1.85:1. Pathologically divided into ulcer type, proliferative type and mixed type.

5, severe abdominal pain, vomiting and other symptoms, such as acute intestinal obstruction, intestinal narrowing and other constipation.

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